Catheter with a contact monitor
Publication Date: 2015-Mar-30
The IP.com Prior Art Database
Positioning medical devices within soft tissue is challenging due to the difficulty of resolving the exact location of the device within the target organ. Especially in the case of cardiac catheterizations, it is often necessary to exactly access specific structures or specific locations in order to achieve the desired effect (i.e. for example during ablation procedures, during the placement of a device in the body during mapping of organs).
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Catheter with a contact monitor
Positioning medical devices within soft tissue is challenging due to the difficulty of resolving the exact location of the device within the target organ. Especially in the case of cardiac catheterizations, it is often necessary to exactly access specific struc- tures or specific locations in order to achieve the desired effect (i.e. for example during ablation procedures, during the placement of a device in the body during mapping of organs).
One specific need for catheterization is during the implantation of cardiac devices within the heart, which are also known as injectable devices or injectable pacemakers or (injectable) leadless pacemakers (ILP). During the positioning of that ILP it is often difficult to determine the exact posi- tion of the guiding catheter with respect to soft tis- sues due to the lack of resolution in fLuoroscopy. In particular it is critical to establish contact with the tissue at an angle that allows full contact of the device with the endocardium - ideally a 90 degree angle with the circumference of the device con- tacting tissue equally. This right positioning is ele- mentary, because a full contact with the endocar- dium ensures delivery of pacing current into the tissue and typically decreases the pacing threshold while raising the pacing impedance, both leading to a longer battery life.
While during the catheterization and the position- ing of the ILP fLuoroscopic techniques like fLuo- roscopic guidance are often used, it is difficult to determine precisely where a delivery system is located within the tissue due to the two-dimen- sional nature of fLuoroscopy and lack of resolution of soft tissues.
Another known solution is an echocardiographic guidance, such as a handheld ultrasound trans- ducer or an ultrasonic probe like a transesopho- geal echo, but these methods do not work with all types of catheterization, are expensive and the procedure is time consuming.
Current ablation systems utilize a force sensing catheter to determine single point contact, but are not oriented to determining a 2- or 3-dimensional contact with a surface. While these force sensing catheters may indicate high contact force, an elec- trically suitable contact with the tissue cannot be achieved.
Known solutions cannot provide knowledge on the intimate contact region of the catheter tool and the target tissue. For instance, contacting a complex region with many fLuid cavities and strands of tissue or muscle will indicate to a force sensor that contact has been established, while not providing circumferential information around a larger format catheter or providing electrical information on the intimacy of contact which will be affected by gaps and cavities underneath the catheter.
In the following, an apparatus to monitor con- tact of a catheter with soft tissue is presented. The proposed apparatus allows the user to moni- tor contact of the catheter with a targeted tissue and optimize the...